PMID- 35152259
OWN - NLM
STAT- MEDLINE
DCOM- 20220215
LR  - 20220311
IS  - 1941-5923 (Electronic)
IS  - 1941-5923 (Linking)
VI  - 23
DP  - 2022 Feb 13
TI  - Pulmonary Function and Chest Computed Tomography (CT) Scan Findings After 
      Antifibrotic Treatment for COVID-19-Related Pulmonary Fibrosis.
PG  - e934830
LID - 10.12659/AJCR.934830 [doi]
AB  - BACKGROUND Physicians worldwide have been reporting many cases of 
      COVID-19-induced pulmonary fibrosis. We report the case of a 51-year-old Filipino 
      asthmatic woman who developed post-COVID-19 pulmonary fibrosis subsequently 
      treated with Nintedanib. CASE REPORT The patient presented with a 4-day history 
      of flu-like symptoms in September 2020 and was eventually diagnosed with severe 
      COVID-19 pneumonia. Despite receiving Dexamethasone, Tocilizumab, Remdesivir, and 
      multiple antibiotics, there was increasing oxygen requirement, necessitating ICU 
      admission and high-flow nasal cannula (HFNC). An additional course of 
      hydrocortisone was given due to asthma exacerbation, gradually liberating her 
      from the HFNC. A chest CT scan showed extensive parenchymal changes, for which 
      she received methylprednisolone and physical rehabilitation with persistence of 
      respiratory symptoms. After 40 days of hospitalization, she was sent home on 
      oxygen support and Nintedanib. The patient initially had severe dyspnea (Borg 
      Scale 7) with 6-minute walk distance (6MWD) of 295 meters. Pulmonary function 
      showed moderately severe restrictive lung defect at 52% predicted total lung 
      capacity (TLC) and severely reduced DLCO (28% predicted). Chest CT scoring 
      indicated severe lung involvement. One month after Nintedanib treatment, her Borg 
      Scale improved to 4. Her 6MWD, TLC, and DLCO increased to 434 meters, 64% 
      predicted, and 36% predicted, respectively. A chest CT scan showed regressing 
      fibrosis. After 6 months of treatment, her pulmonary function normalized. DLCO 
      remained moderately reduced (59% predicted) but her 6MWD (457 meters) and CT scan 
      results continued to improve. CONCLUSIONS Nintedanib, along with other 
      interventions, may have potentially improved pulmonary function and CT scan 
      findings in a COVID-19 survivor with pulmonary fibrosis 6 months after treatment.
FAU - Lomanta, Jan Michael Jesse
AU  - Lomanta JMJ
AD  - Division of Pulmonary Medicine, Department of Medicine, Philippine General 
      Hospital, Manila, Philippines.
FAU - Quinto, Milraam L
AU  - Quinto ML
AD  - Division of Pulmonary Medicine, Department of Medicine, Philippine General 
      Hospital, Manila, Philippines.
AD  - Department of Medicine, St Lukes Medical Center, Bonifacio Global City, 
      Philippines.
FAU - Urquiza, Sheen C
AU  - Urquiza SC
AD  - Department of Radiology, Philippine General Hospital, Manila, Philippines.
FAU - Santiaguel, Joel M
AU  - Santiaguel JM
AD  - Division of Pulmonary Medicine, Department of Medicine, Philippine General 
      Hospital, Manila, Philippines.
AD  - Department of Medicine, Quirino Memorial Medical Center, Quezon City, 
      Philippines.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220213
PL  - United States
TA  - Am J Case Rep
JT  - The American journal of case reports
JID - 101489566
SB  - IM
MH  - *COVID-19
MH  - Female
MH  - Humans
MH  - Lung
MH  - Middle Aged
MH  - *Pulmonary Fibrosis/diagnostic imaging/etiology
MH  - SARS-CoV-2
MH  - Tomography, X-Ray Computed
PMC - PMC8850995
COIS- Conflict of interest: None declared
EDAT- 2022/02/14 06:00
MHDA- 2022/02/16 06:00
PMCR- 2022/02/13
CRDT- 2022/02/13 20:36
PHST- 2022/02/13 20:36 [entrez]
PHST- 2022/02/14 06:00 [pubmed]
PHST- 2022/02/16 06:00 [medline]
PHST- 2022/02/13 00:00 [pmc-release]
AID - 934830 [pii]
AID - 10.12659/AJCR.934830 [doi]
PST - epublish
SO  - Am J Case Rep. 2022 Feb 13;23:e934830. doi: 10.12659/AJCR.934830.